What TIME Asked Tigress About Health

In addition to the feature story at Time.com and in Time’s May 13th edition, Time asked each 100 Health honoree to answer several question broader questions about health and healthcare.

Here are the answers from our Executive Director, Tigress Osborn. (None were used in the print or digital edition of TIME).

What do you think is the most pressing threat to human health in 2024?

Corporate greed and wealth hoarding are the most pressing threats to human health in 2024. Everything that impacts our health is determined by who makes money off the problems or the solutions, or by who is stockpiling resources while others go without. There are many well-intentioned people in the system who genuinely care about health, but their work is limited by its profitability. It sometimes seems that health is a byproduct of business if we’re lucky, rather than the actual goal.

What health-related issue do you think deserves more attention and/or funding, other than your own area of focus?

Globally, genocide is an immediate danger to millions of people right now. 

Domestically, racial disparities in healthcare show up in everything from scientific research, to diagnosis and treatment of life-threatening conditions, to access to daily needs. By most measures, non-white people receive lower quality care and are at risk of more health conditions, yet we are still too often behaving as though healthcare is race-neutral. We don’t talk enough about the social determinants of health, and we don’t talk enough about how racial bias within the healthcare system compounds the racial bias faced outside of it. Disparities in education, employment, and justice lead directly to negative and all-too-often life threatening or deadly outcomes. Public health and racism are treated as separate political issues, but they are absolutely not. Systemic racism is a public health crisis.

What is the most promising health innovation from the past year, other than your own?

As important as innovation can be, when it comes to the population I work most closely with and for, a focus on innovation—specifically decades of searching for a weight loss “miracle cure”–-actually detracts from the care we need now. Larger-bodied people don’t too often don’t have access to the health opportunities and options available. The existing information, technology, and resources frequently leave us out, so we can’t assume that future innovations will take us into account. Research and developments that include larger bodies, but that don’t have an end goal of shrinking us, are underfunded and under-supported because we are insistent that eradicating fat is the best and only way to better health. So much innovator energy in medical science is going to what is seen as the stubborn problem of unfatting people, and some of that energy and money could be spent on ways to help fat people be healthier regardless of whether or not we can help them be thin. 

The nearly constant focus on the next “solution” to fat shifts the entire culture toward addressing discrimination, stigma, and oppression by changing bodies rather than by changing discriminatory, stigmatizing, or oppressive behaviors, beliefs, and systems. We’ve been “treating” and “preventing” obesity for decades, and after years of being told these treatments would be life-saving innovations at both individual and population levels, instead we’re still being told that most people are just too fat. Maybe the problem we’ve been trying to solve is not the one that needs to be solved. When it comes to bigger bodies, maybe we need to focus our innovator energy in some different directions. Can we innovate ways to talk about fatness that are not exclusively pathological? Can we innovate new approaches that replace the highly problematic Body Mass Index, but ones that don’t simply group all people who are beyond a certain size as automatically and inherently diseased? Can we innovate more accessibility—socially and physically—for larger bodies in health and wellness spaces? 

What forthcoming health innovation are you most excited about, other than your own?

I’m excited that there has been some increase in the amount of size-inclusive and truly accessible devices and other equipment  making their way to medical offices and hospitals. I hope to see even more of that in the future. I want to live in a world that includes everyone from curious college students to the well-resourced manufacturers of equipment all working on designing and developing technology that takes all bodies into consideration. For example, I once had an ophthalmologist, a complete stranger to me, write to tell me that I could never have received an eye exam in her office, because I am too big for the exam equipment there. Luckily for me and my eyes, my own ophthalmologist has never exhibited any bias and the equipment at his office works just fine for me. But there is no doubt someone else it doesn't work for, because of size or disability or something else. I love the idea of handing that letter to a team of scientists and engineers and letting them go to work on how equipment can be changed to accommodate bodies rather than how bodies should be changed to accommodate equipment. I’m thankful to those who are already doing such work, and thrilled that there is more of it to come.

Who in the health field is doing work that makes you jealous, and what is the work?

I’m certainly jealous of the amount of funding and attention that goes into obesity research and prevention compared to the amount of funding that goes into work related to fat rights, body sovereignty, or Health at Every Size® approaches to wellness. The medical students, researchers, doctors and other medical professionals who are willing to rock the boat and challenge the status quo around how we think of fat bodies are really inspirational to me, and their growing number is essential to furthering the work of ensuring that people of all body sizes receive care in medicine and in all realms of life.